Woods Hutchinson

“ In medicine, as in war, the gravest and deadliest mistake that you can make is to despise your enemy. These trivial disorders, these trifling ailments, which every one takes as a matter of course, and expects to go through with, like teething, tight shoes, and learning to smoke, sweep away every year in these United States the lives of from forty to fifty thousand children, reaching the bad eminence of fifth upon our mortality lists, only consumption, pneumonia, heart disease, and diarrhœal diseases ranking above them. ”

“ It is our pride that medicine, from an art, and a pretty black one at that, originally, is becoming a science. And the most powerful factor in this development, its indispensable basis, in fact, has been the invention of instruments of precision—the microscope, the fever thermometer, the stethoscope, the ophthalmoscope, the test-tube, the culture medium, the triumphs of the bacteriologist and of the chemist. Any man who makes a final diagnosis in a serious case without resorting to some or all of these means is regarded—and justly—as careless and derelict in his duty to his patient. ”

“ There is no more genuine and obstinate malady on earth than a nervous disease. Because nerves lie in that twilight borderland between mind and matter, body and soul, the real and the ideal, the impression has got abroad that they are little better than figures of speech. Though their disturbances give rise to visions of all sorts there is nothing visionary about them; they are just as genuine and substantial a part of our bodily structure as our bones, muscles, and blood-vessels. ”

“ No sooner does the primitive human hive reach that degree of density which is the one indispensable condition of civilization, than it is apt to breed a pestilence which will decimate and even scatter it. Smallpox, cholera, and bubonic plague have blazed up at intervals in the centres of greatest congestion, to scourge and shatter the civilization that has bred them. No civilization could long make headway while it incurred the dangers from its own dirtiness; and to-day the most massive and imposing remains of past and gone empires are their aqueducts, their sewers, and their public baths. ”

“ If on the other hand, the food-supply is inadequate, if the sleep allowance has been cut short, whether by the demands of work or by those of fashion, if the body has been starved of oxygen and deprived of sunlight, if the whole system has been kept on the rack, whether in the sweatshop, or in the furnace of affliction, what is the effect on the nervous system? Just what might have been expected. The sense-organs shy, like a frightened horse, at every shadow or fluttering leaf. ”

“ The first was the great resisting power and vigor of the human organism, which we had gravely underestimated. The second, that power of adaptation to new circumstances, including even the attack of infectious diseases, which we call "survival of the fittest." The third, that great, sustaining, conservative power of nature—heredity. More cheering yet, these forces came, not merely fully armed, but bearing new weapons fitted for our hands. The vigor and unconquerable toughness of the human animal presented us with three glittering weapons, sunshine, food, and fresh air. ”

“ We little realize the fiendish resourcefulness of the cancer-cell. One such adrift in the body is like a ferret in a rabbit warren; no other cell can face it for an instant. It simply floats unmolested along the lymph-channels until its progress is arrested in some way, when it promptly settles down wherever it may happen to have landed, begins to multiply and push out columns in every direction, into and at the expense of the surrounding tissues, and behold, a new cancer, or "secondary nodule," is born (metastasis) . ”

“ So long as the flying shuttle keeps moving in its restless course to and fro, life is. A single stop is death. The very same blow which, rightly placed, sends it like an arrow to the safe centre of the opposing racket, if it fall obliquely, or even with too great or too little force, drives it perilously wide of its mark. It can recover the safe track only by a sudden and often violent lunge of the opposing racket. The straight course is life, the tangent disease, the saving lunge recovery. ”

“ As with the painter, next to line comes color. Every one, of course, knows that a fresh, rosy color is usually associated with health, while a pale, sallow complexion suggests disease. But our color signals, while more vivid, are much less reliable and more apt to deceive than our line-markings.
Surprising as it may sound, careful analyses have shown, first, that the kind of pigment present in the human skin of every race is absolutely one and the same. The only difference between the negro and the white man is that the negro has two or three times as much of it. ”

“ All our processes of repair, all the reactions of the body against the attack of accident or of disease, are hereditary endowments, worked out with infinite pains and labor through tens of thousands of generations. The utmost that we can do with our drugs and remedies is to appeal to and rouse into action the great healing power of nature, the classic "Vis medicatrix Naturæ," an incarnation of our past experiences handed down by heredity. ”

“ SCARLET FEVER, MEASLES, AND WHOOPING-COUGH
Why is a disease a disease of childhood? First and fundamentally, because that is the earliest period at which a human being can have it. But the problem goes deeper than this. There is no more interesting and important group of diseases in the whole realm of pathology than those which we calmly dub "the diseases of childhood," and thereby dismiss to the limbo of unavoidable accidents and discomforts, like flies, mosquitoes, and stubbed toes, which are best treated with a shrug of the shoulders and such stoic philosophy as we can muster. ”

“ The man who would depend upon the confidence of his patients as a means of healing, would soon find himself without practice. We know by the bitterest of experience that no matter how absolute and boundless the confidence of our patients may be in our ability to heal them, no matter how much they may express themselves as cheered and encouraged by our presence, ninety-nine per cent of the chance of their recovery depends upon the gravity of the disease, the vigor of their powers of resistance, and our skill and intelligence in combating the one and assisting the other. ”

“ By a humiliating paradox we are never quite able to put ourselves under those conditions which we know to be ideal from a sanitary point of view. There are too many prejudices, too many vested interests, too many considerations of expense to be reckoned with. But with the lower animals that come under our care we have a clear field, free from obstruction by either our own prejudices or those of others. In this realm the stamping out of tuberculosis is not merely a rosy dream of the future but an accomplished fact, in some quarters even an old story. ”

“ Our alienists now claim that, by checking the reproduction of the obviously unstable, and careful hygienic treatment and training of the predisposed two per cent, insanity is almost as preventable as tuberculosis.
In fine, from all the broad field of pathology, the mists of tradition which have dimmed the fair name and reputation of heredity are slowly but surely lifting, until we now behold it, not as our worst enemy, but as our best friend in the prevention of disease and the upbuilding of the race. ”

“ The bowed back, the droop of the shoulders, the hanging jaw, and the shuffling gait, tell the story of chronic, wasting disease more graphically than words. We have a ludicrously inverted idea of cause and effect in our minds about "a good carriage." We imagine that a ramrod-like stiffening of the backbone, with the head erect, shoulders thrown back and chest protruded, is a cause of health, instead of simply being an effect, or one of the incidental symptoms thereof. ”

“ I have waked in the morning with the snow drifting across the back of my neck, been wet to the skin all day, and gone to bed in my wet clothes, and slept myself dry; and have lain out all day in a November gale, in a hollow scooped in the half-frozen ground of the duck-marsh, and felt never a hair the worse. Scores of similar experiences will rise up in the minds of every camper, hunter, or fisherman. You may catch cold during the first day or two out, before you have got the foul city air, with its dust and bacteria, out of your lungs and throat, but even this rarely happens. ”

“ No sooner did the army surgeon and medical missionary settle down in the wake of that extraordinary world-movement of Teutonic unrest, which has resulted in the colonization of half the globe within the past two or three hundred years, than it was discovered that, although the hunting or nomad savage had not developed tuberculosis, and the disease was emphatically born of civilization, yet the moment that these healthy and vigorous children of nature were exposed to its infection, instead of showing the high degree of resisting power that might be expected, they died before it like sheep. ”

“ The human automobile in its million-year endurance-run has had to learn to become self-repairing; and well has it learned its lesson. Not only, in the language of the old saw, is there "a remedy for every evil under the sun," but in at least eight cases out of ten that remedy will be found within the body itself. Generations ago this self-balancing, self-repairing power was recognized by the more thoughtful fathers in medicine and even dignified by a name in their pompous Latinity—the vis medicatrix naturæ, the healing power of nature. ”

“ Against the frankly foreign epidemic enemies of the race a sturdy and, of late years, a highly successful battle has been fought. We have banished the plague, drawn the teeth of smallpox, riddled the armor of diphtheria, and robbed consumption of half its terrors. In spite of the ravings and gallery-play of the Lombroso school anent "degeneracy," our bills of mortality show a marked diminution in the fatality of almost every important disease of external origin which afflicts humanity. ”

“ Underneath all this storm and stress of the fever paroxysm, nature is quietly at work elaborating her antidote. In some marvelous fashion, which we do not even yet fully understand, the cells of the body are producing in ever-increasing quantities an anti-body, or antitoxin, which will unite with the toxin or poison produced by the hostile germs and render it entirely harmless. By a curious paradox of the process, it does not kill the germs themselves. It may not even stop their further multiplication. Indeed, it utilizes part of their products in the formation of the antitoxin ”

“ This recognition of the natural causation and development of disease has been one of the greatest triumphs, not merely of pathology, but of intelligence and rationalism. It has done more to diminish that dread of the unknown which hangs like a black pall of terror over the mind of the savage and the semi-civilized mind than any other one advance. ”

“ Malaria has probably killed more human beings than all the wars that have ever devastated the globe. Some day the epic of medicine will be written, and will show what a large and unexpected part it has played in the progress of civilization. Valuable and essential to that progress as were the classic great discoveries of fire, ships, wheeled carriages, steam, gunpowder, and electricity, they are almost paralleled by the victories of sanitary science and medicine in the cure and prevention of that greatest disrupter of the social organism—disease. ”

“ To remedy conditions of mental stress by correcting the underpay, overwork, bad ventilation, or underfeeding on account of illness or death of the wage-earner of the family, is, of course, nothing but the most admirable common sense; but to call it the mental treatment of disease is a mere juggling with words. "Take care of the body and the mind will take care of itself," is a maxim which will prove valid in actual practice nine times out of ten. ”

“ The mosquito-brigade have still another method of checking the spread of malaria, at first sight almost a whimsical one,—no less than screening the patient. The mosquito, of course, criminal as she is, does not hatch the parasites de novo in her own body, but simply sucks them up in a meal of blood from some previous victim. Hence by careful screening of every known case of malaria, mosquitoes are prevented from becoming infected and transmitting the disease. Instead of the screens protecting the victims from the mosquitoes, they protect the mosquitoes against the victim. ”

“ Moreover, it was only in the last ten years, yes, within the last five years, that we fairly grasped the real method and nature of the spread of the disease, and recognized the means that must be adopted against it. And as all of these factors are matters which are not only absolutely within our own control, but are included in that programme of general betterment of human comfort and vigor to which the truest intelligence and philanthropy of the nation are now being directed, the outlook for the future, instead of being gloomy, is distinctly encouraging. ”